Breast Cancer Research and Treatment

, Volume 130, Issue 3, pp 809–816

The prognostic role of circulating tumor cells (CTCs) detected by RT-PCR in breast cancer: a meta-analysis of published literature

  • Shu Zhao
  • Yupeng Liu
  • Qingyuan Zhang
  • Hongbin Li
  • Minghui Zhang
  • Wenjie Ma
  • Wenhui Zhao
  • Jingxuan Wang
  • Maopeng Yang
Preclinical study

Abstract

The prognostic significance of circulating tumor cells (CTCs) in patients with breast cancer is controversial. We performed a meta-analysis of published literature to assess whether the detection of CTCs in patients diagnosed with primary breast cancer can be used as a prognostic factor. We searched Medline, Science Citation Index, and Embase databases as well as reference lists of relevant articles (including review articles) for studies that assessed the prognostic relevance of tumor cell detection in the peripheral blood (PB). A total of 24 eligible studies with 4,013 cases and 1,333 controls were included. Meta-analyses were performed using a random-effects model, using the hazard ratio (HR) and 95% confidence intervals (95% CIs) as effect measures. The positive detection of CTCs in patients was significantly associated with poor overall survival (OS) (HR = 3.00 [95% CI 2.29–3.94], n = 17, P < 0.0001) and recurrence-free survival (RFS) (HR = 2.67 [95% CI 2.09–3.42], n = 22, P < 0.0001). CTC-positive breast cancers were significantly associated with high histological grade (HR = 1.21 [95% CI 1.09–1.35], n = 34, P < 0.0001), tumor size (>2 cm) (HR = 1.12 [95% CI 1.02–1.22], n = 31, P = 0.01). and nodal status (≥1) (HR = 1.10 [95% CI 1.00–1.21], n = 32, P = 0.037), but cytokeratin-19 (CK-19) mRNA-positive CTCs were not associated with these clinicopathological parameters of breast cancer. Furthermore, the presence of CTCs was not associated with estrogen receptor (ER) negativity, progesterone receptor (PR) negativity, or human epidermal growth factor receptor type 2 (HER2) positivity. Detection of CTCs in the PB indicates poor prognosis in patients with primary breast cancer. Larger clinical studies are required to further evaluate the role of these markers in clinical practice.

Keywords

Circulating tumor cells Breast cancer Prognosis RT-PCR 

Supplementary material

10549_2011_1379_MOESM1_ESM.doc (130 kb)
Supplementary material 1 (DOC 130 kb)

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Shu Zhao
    • 1
  • Yupeng Liu
    • 2
  • Qingyuan Zhang
    • 1
  • Hongbin Li
    • 1
  • Minghui Zhang
    • 1
  • Wenjie Ma
    • 1
  • Wenhui Zhao
    • 1
  • Jingxuan Wang
    • 1
  • Maopeng Yang
    • 1
  1. 1.Department of Internal MedicineThe Third Affiliated Hospital of Harbin Medical UniversityHarbinChina
  2. 2.Department of EpidemiologyPublic Health College of Harbin Medical UniversityHarbinChina

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